A NEW LAW THAT WILL CHANGE the way Utah pharmacists work began with a question that was part of a classroom assignment: “If you had one wish for a pharmacy dream bill, what would it be?” At the time, Wilson D. Pace, Pharm.D., was a University of Utah College of Pharmacy graduate student in the school’s leadership and advocacy class taught by David C. Young, Pharm.D. He immediately thought of the need for broader access to contraception and how pharmacists can fill that gap.
This issue hit home for Dr. Pace because his wife had experienced problems obtaining a prescription for a contraceptive from an obstetrician since a shortage of providers made her wait several months to get an appointment. As he further looked into the challenges women face getting contraception in a timely manner, he found that his wife’s experience was far from unique. As a result, Dr. Pace came to the conclusion that if there were a law that gave pharmacists the power to provide contraception without a new prescription, it would go a long way toward advancing women’s health in the state. This idea moved Dr. Pace to seek out other student pharmacists to form a working group. Together they started an advocacy campaign that would make this dream bill a reality.
Garnering Support from Medical Stakeholders
Dr. Pace and his working group began by reaching out to pharmacist mentors about their desire to take action on this idea in the hopes that the legislature would act on it. The pharmacists discussed how the advocacy process would work, and based on his prior experience, Dr. Young knew they first had to gain the support of various stakeholders in the state. Although groups such as Utah Board of Pharmacy, professional pharmacy organizations, the Utah Medical Association, and nursing organizations agreed that it was essential to address the issues women face while trying to obtain contraceptives, they had yet to agree on the exact role pharmacists should play in solving them. Specifically, whether or not pharmacists should be able to provide contraceptives without a prescription from a doctor.
As a result, Dr. Pace’s original vision of pharmacists having prescribing power was a point of contention during the discussions and ultimately something on which Drs. Pace and Young needed to compromise to get the groups’ support and move forward. In the end, the stakeholders all decided it was best for pharmacists not to have full prescribing power, but to be able to provide contraception without a prescription on a limited basis.
“We didn’t sit around the fire singing ‘Kumbaya,’” said Dr. Young. “We had very healthy, open, and honest discussions about what the idea for a new law meant, how we were going to accomplish it, and how we were going to work together.”
Hammering Out the Details
After completing discussions with all of the healthcare stakeholders and getting their support, it was time to work with the legislative research office to refine the language of the bill. This was a complicated and lengthy process because it required that every interested group sign off on each revision that was made to the draft.
“Any tiny change had to have buy-in from all of the different groups,” Dr. Pace said. “So the next big step was working out all the nuts and bolts and then coordinating to make sure everybody was on the same page.”
Legislative Support
Once the language of the bill was finalized, it was time to get legislative support. Finding the right sponsor was vital. Sen. Todd Weiler agreed to sponsor the bill, and Rep. Ray Ward, M.D., a family physician with a history of working on legislation related to improving public health, co-sponsored the bill. “We actually had no opposition. We were concerned that there might be different groups testifying against us or they would push back, but there was none of that,” said Dr. Pace.
The process went so smoothly that there were no opposing testimony delivered when the bill was in committee and no opposing votes in the Utah Legislature. In March, Gov. Gary Herbert signed S.B. 184.
Thanks to the efforts of Dr. Pace, the other student pharmacists involved, and guidance from their mentors, women in Utah can now get contraception from pharmacists for two years before being required to check in with a doctor for a new prescription.
“I believe this law will allow pharmacists in the state of Utah to demonstrate the value they bring to patient care, and also the team-based approach to care that pharmacists have,” said Karen M. Gunning, Pharm.D., BCPS, a Professor (Clinical) at the University of Utah College of Pharmacy, who provided expert knowledge and support to Drs. Pace and Young as they navigated the legislative process. “There is great potential for pharmacists to work with medical providers in their communities to improve access, and to ensure that patients who need contraceptive care from a non-pharmacist medical provider are referred promptly to one.”
A Future of Advocacy
With this significant advocacy win under his belt, Dr. Pace admits that he’s been bitten by the political bug and will continue working toward furthering the interests of the pharmacy profession. Drs. Pace and Young, now co-chairs in the legislative committee of the Utah ASHP state affiliate, have already begun exploring new issues to tackle in the current legislative session.
“Whatever job I end up being in, I can’t imagine not being involved in some way in the advocacy process,” Dr. Pace said.
Although at first blush many pharmacists may shy away from doing advocacy work, Dr. Young urges all pharmacy professionals to consider getting involved because of the tremendous impact it can have on the way they work in their state.
“If you’re not interested in advocating for your profession, other people may change the laws and rules on you, and you may not like it,” he said. “If you want to control your outcomes, you’ve got to get involved. The best way to control your destiny is to create it — and that’s what happened with this bill.”
By Kenya McCullum